Objective: To compare the quality of interpretation of chest helicoidal computed tomography (HCT) by physicians with different levels of experience and medical specialty.Design: Prospective observational study.Setting: Trauma critical care unit at a French university hospital (US equivalent: level 1).Patients: HCT of 50 consecutive patients with blunt chest trauma were assessed by four groups of physicians [residents in anaesthesiology (n=5), residents in radiology (n=5), senior anaesthesiologists (n=5), and senior radiologists (n=5)]. Interpretation from each physician was compared with a grid obtained from an expert interpretation by a senior radiologist and a senior anaesthesiologist.Interventions: None.Measurements and Main Results: No group of observers performed better than another in their interpretation of lung and parietal injuries on HCT. In contrast, senior radiologists were better than anaesthesiologists for the diagnosis of pneumomediastin. However, residents in radiology performed better than other physicians in detecting the presence of gastric and tracheal tubes.Conclusions: Compared with anaesthesiologists, senior radiologists seem more expert in the diagnosis of HCT mediastinal injuries whereas residents in radiology were better at detecting resuscitation materials in thoracic trauma patients. This article reinforces the usefulness of the interpretation of the HCT by a senior radiologist in the case of blunt chest trauma. This also reinforces the usefulness of an aspect team of radiologists and anaesthesiologists in the case of trauma. The logical usefulness of a systematic interpretation of the images should be borne in mind.

Purpose: Delivery of enteral nutrition (EN) to ICU patients is commonly interrupted for diagnostic and therapeutic procedures. We investigated this practice in a cohort of trauma and surgical ICU patients. Methods: This was a retrospective single-center study conducted in a 15-bed trauma ICU of...

In early 2015, the Medical Board of Australia commissioned research into international revalidation models and what might be applicable for Australia. This review examines the implications for Australian anaesthetists. What problem is revalidation seeking to address? What is happening in similar...

Background: Care of the polytrauma patient does not end in the operating room or resuscitation bay. The patient presenting to the intensive care unit following initial resuscitation and damage control surgery may be far from stable with ongoing hemorrhage, resuscitation needs, and injuries still...

Reports on the findings of a study comparing albumin and normal saline for fluid resuscitation. Rates of death and organ failure; Length of stay in the hospital and in the intensive care unit; Days of mechanical ventilation and renal-replacement therapy.

Purpose: To investigate the interchangeability of mixed and central venous-arterial carbon dioxide differences and the relation between the central difference ( pCO gap) and cardiac index (CI). We also investigated the value of the pCO gap in outcome prediction. Methods: We performed a post hoc...

Introduction: Do not resuscitate (DNR) is an important aspect of medical practice, although few studies from Arab Muslim countries address this issue. King Abdulaziz Medical City (KAMC), Saudi Arabia has a policy addressing all aspects of patient care at end of life. Objective: To assess...

Background: age is thought to be strongly associated with intensive care outcomes, but this relationship may be confounded by many clinical variables. Objectives: to compare clinical characteristics of elderly patients (â‰¥65 years) admitted to the intensive care unit (ICU) with those in...

Objectives: To determine the difference in aspiration rates between gastrically and transpylorically fed patients in the intensive care unit. Design: A prospective controlled study of critically ill patients randomized to receive either a gastrically placed feeding tube or a transpylorically...

Background: In order to identify relevant targets for change, it is essential to know the reliability of incident staff reporting. The aim of this study is to compare the incidence and type of unintended events (UE) reported by facilitated Intensive Care Unit (ICU) staff with those recorded...